J Korean Med Assoc.  2022 Apr;65(4):197-201. 10.5124/jkma.2022.65.4.197.

Diagnosis of varicose veins

• Ohe HJ
• Kim SY

• KMID: 2529238
• DOI: http://doi.org/10.5124/jkma.2022.65.4.197

Abstract

Background
Varicose veins refer to tortuous engorged veins on the lower extremities. Although this is a common condition observed in clinical practice, objective diagnosis is important for optimal treatment.
Current Concepts
Thorough physical examination is the first key step for diagnosis of varicose veins. Both legs should be examined between the inguinal region and the feet with the patient in an erect position. The presence and location of venous reflux should be confirmed using duplex ultrasonography (DUS), which serves as a simple, non-invasive modality to assess both the anatomy and physiology of leg veins. Reflux is defined as duration of retrograde flow greater than 0.5 seconds in superficial veins, 0.35 seconds in perforating veins, and 1.0 seconds in deep veins. Computed tomography venography can be used in selective cases as a complementary tool to obtain objective images of all varicose veins; however, this imaging modality cannot confirm venous reflux.
Discussion and Conclusion
DUS is a key diagnostic tool for varicose veins. However, DUS results are operator dependent; therefore, this procedure should be performed by experienced technologists or clinicians, based on guidelines. The location and duration of reflux should be recorded.

Keyword

Varicose veins; Diagnosis; Duplex doppler ultrasonography; 하지정맥류; 진단; 이중도플러초음파